| NPI | 1902121544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA A117954) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MI 4301512517) |
| Enumeration Date | 2010-04-06 |
| Last Update Date | 2024-07-09 |